Kumail Nanjiani is
a Pakistani-born American living and working in Chicago. In addition to driving
for the ride-sharing company Uber, Kumail performs as a stand-up comic at a
local club, hoping to be noticed and land a big break. During one of his
shows, he meets a graduate student named Emily Gardner, and the two quickly
develop an intimate relationship.

Kumail hides his
relationship from his family, because they insist that he only date Pakistani
women. Privately, Kumail struggles not only with the cultural expectation of
intra-ethnic marriage, but also with other aspects of his heritage, such as
devotion to Islamic religious law. He chooses to maintain appearances out of
love for his family and fear of disownment. Emily eventually discovers Kumail’s
double life and in anger, ends their relationship.

Kumail and Emily’s
estrangement is interrupted when Emily is hospitalized with a mysterious
illness. Emily initially resists Kumail’s presence, but her sickness worsens
and she is placed in a medically-induced coma. Under these increasingly
uncertain circumstances, Kumail partners with Beth and Terry—Emily’s parents—to
navigate a confusing medical system and chart the best course of care for Emily.
The three of them clash over their differing perspectives on care and their
interpersonal relationships. As he waits with bated breath for Emily’s
recovery, Kumail is forced to confront his values and decide whether his desire
to please his family and his ongoing affection for Emily can coexist
harmoniously.

The idea for her second novel came to Sarah Perry in a flash
(Ref. 1) as her husband was telling her about the 1699 sighting of a serpent or
dragon in Henham, a village slightly to the northwest of the town of Essex,
where Ms.Perry was born in 1979. The late 19th century events of the novel
occur primarily in Aldwinter, a fictional fishing village on the Blackwater
estuary. Divided into 4 books (with
titles derived from a 1669 pamphlet on the Serpent), each with subdivisions by
month, further subdivided into chapters, the story takes place over 11 calendar
months, from New Year's Eve to November, 1892. Although the story does not feel
complicated and should not be difficult to describe in a synopsis, it is a
tribute to the novelist's Dickensian talents
that in fact it is somewhat complex, involving four couples and their
various children and friends and their increasingly intricate relationships,
all revolving around the palpable feeling in Aldwinter that the famous Essex
Serpent has returned, resurfaced, or decided to re-animate all the lives
therein. The protagonist is Cora Seaborne, a recently widowed free-thinker, adept in
biology and natural sciences, and mother of an adolescent boy, Francis, who
would nowadays probably receive the label "autistic." After the death
of her abusive husband from oropharyngeal cancer, Cora becomes emotionally
involved with Luke Garrett, the treating surgeon, an idiosyncratic, brilliant man, who has a bosom buddy, George Spencer (simply called "Spencer"), a
very wealthy former medical school classmate. With an introduction from her friends
Charles and Katherine Ambrose, Cora and Martha - her intimate companion - visit
William (often referred to as just "Will") and his wife Stella
Ransome in Aldwinter, where Will is the parish minister and father to three
children. The eldest is Joanna, a precocious adolescent girl one imagines,
alongside a younger Cora, as a younger version of this novel's author, who
describes herself as vibrantly curious of all her surroundings while growing up
in Essex as a young girl. (Ref. 2)

With the arrival of Cora and Martha in Aldwinter, the narrative begins in earnest
with the development of the mounting anxiety over the mysterious events (a
missing boat, unexplained drownings) attributed to possibly a resurgent Essex
Serpent besetting Aldwinter; Luke's miraculous operation saving a man named
Edward Burton from a knife wound to the heart; the increasingly romantic
relationship between Cora and Will, to Luke's dismay; Stella's rapidly
progressive pulmonary tuberculosis; the disappearance of Naomi Banks, a friend
of Joanna; and an attack on Luke by the same man who had knifed Edward Burton.
By novel's end, without spoiling the plot, most loose ends have been
cauterized, left more neatly dangling or deftly retied.

The Alice Neel painting, T.B.
Harlem, can be seen at the National Museum of Women in Arts in Washington, D.C.

We are looking at a young man who has tuberculosis (TB) and
who is at home recovering from a surgical procedure designed to collapse a part
of his lung that is infected. He looks sick. His presentation conveys how TB
can be called “consumption.” From this picture, however, we can tell that it is
not just the subject’s body that is being consumed, but also his spirit and any
reservoir of hope.
The painting appeared on the cover of the June 8, 2005 issue
of the Journal of the American Medical
Association (JAMA).
In his accompanying essay, William Barclay, a pulmonary specialist, surmises
that “thoracoplasty” was the surgical procedure used for this person. The
procedure involves the removal of several ribs so that the soft tissue the ribs
held up collapses upon the lung and closes it off. Barclay calls thoracoplasty “the
most radical form of collapse treatment” at the time. He also notes how Neel
captured the anatomical consequences of the procedure: His
body forms a graceful sigmoid curve, for a thoracoplasty always resulted in a
thoracic scoliosis from the pull of the muscles on the side not operated on,
with a compensatory cervical scoliosis in the opposite direction.A white wound dressing on
the left side of the subject’s chest draws our attention because of its
brightness and because the subject’s right hand is pointing to it. It’s not
covering the surgical incision because that’s on his back. Barclay suggests
that the dressing is covering a wound that opened up a track from the skin to
the chest lining or to the lung (i.e., a fistula). The dressing takes the shape
of a cross, which made the writer of the text accompanying the painting at the
museum where it hangs wonder if we are to see the subject as a martyr in the
form of Christ.

Edvard
Munch’s painting, The Sick Child, hanging in the Tate in London, England is his fourth version of the painting. This version is done in oil on canvas and was
completed in 1907. The first version was painted in 1885. As
we come upon this painting, we quickly realize we are standing at the end of a
bed intruding upon a poignant moment. In this impressionistic painting, we can
discern an adolescent girl propped up in bed. She is facing an older woman
sitting at her side. We don’t see this woman’s face because her chin is on her
chest in a way that makes her look distraught. We can easily conclude that she
is the girl’s
mother and that the girl is sick, very sick.

When we look around the room with the view Munch gives us, we see little in the way of medical
supplies or equipment. There is only a bottle on a nightstand that might be
some potion and a glass of water on a dresser. Nothing more is to be done for
this child. She seems to know it and so she tries to comfort the woman who
is attending her. The painting reminds the viewer that often those who are dying offer comfort to the ones attending them as well.

Born in 1894, Grania becomes deaf following scarlet fever at the age of two. Her mother never quite recovers from misplaced guilt over this outcome and is withdrawn. But Grania is well loved by the whole family, who run a hotel in a small town. Her older sister and their Irish-born grandmother see the child's intelligence and find ways to communicate with her by signs and words; they urge the parents to send her to a special school.By age nine, Grania is sent to the famous School for the Deaf in Belleville Ontario, founded by Alexander Graham Bell. Although the school is only a short distance from her home on the north shore of Lake Ontario, the child is not allowed to return for nine long months. At first she is overwhelmed with homesickness, but soon she finds kindred spirits among the other students and teachers and adapts to the life of the institution.

By 1915, her studies complete, Grania works at the school. There, she meets her future husband, Jim, a hearing man who is assistant to the town doctor. They marry, but only two weeks later, Jim leaves to serve as a stretcher bearer in the war in Europe. Fear and death haunt the people at home and abroad for years. Jim writes what little he is allowed of the horror and danger around him, always promising to return. Grania waits and writes too, slowly growing hopeless and angry, as devastating telegrams arrive one after the other.Her sister copes with the return of a grievously disfigured husband, wounded more in mind than in body. In late 1918, Grania falls ill in the influenza epidemic and is delirious for weeks. When she recovers, frail and bald, she learns of the loss of her beloved grandmother who died of the fever caught by nursing her. At the same moment she hears of the war's end and begins to believe again in hope.

New York, 1981. As
the play opens, Ned Weeks sits outside a doctor’s office with a friend who has
developed worrisome symptoms of a mysterious “plague” that strikes
homosexuals. The doctor, Emma Brookner,
complains that she cannot make headway in getting the gay community to take the
threat seriously. This encounter
inspires Ned, a writer, to dedicate himself to becoming the spokesman for the
growing ranks of disenfranchised patients. He attempts to convert others to his
cause, including his heterosexual brother, a closeted bank executive, and a reporter
for the New York Times (whom he begins to date). When it becomes clear that the City is not
interested in assisting, he co-founds a grassroots activist organization. As the epidemic veers out of control, the man
he loves falls ill as well. Over time,
Ned’s abrasive, confrontational approach, as well as his focus on abstinence,
makes him many enemies within the gay community. Ultimately, he is forced out of his own
organization. At the same time, there
are hints that, as a result of his work, the disease is beginning to be taken
seriously. At the end of the play, Ned’s
lover Felix becomes the latest gay man to succumb to the epidemic.

The author, an experienced surgeon, believes that we will be less frightened by the prospect of death if we understand it as a normal biologic process. He points out that 80 percent of deaths in this country now occur in hospitals and are therefore "sanitized," hidden from view, and from public comprehension. He describes the death process for six major killers: heart disease, stroke, AIDS, cancer, accidents/suicide, and Alzheimer's disease.But the power of the book is in its intensely personal depiction of these events and in the lessons which Nuland draws from his experiences. The message is twofold: very few will "die with dignity" so that (1) it behooves us to lead a productive LIFE of dignity, (2) physicians, patients, and families should behave appropriately to allow nature to take its course instead of treating death as the enemy to be staved off at any cost. Only then will it be possible for us to die in the "best" possible way--in relative comfort, in the company of those we love/who love us.

Children wasting away, in pain, infected with parasites whose life cycle continues "bodies to fingers, / fingers to lips, of lips to eggs / and eggs to worms." That cycle is echoed in the human experiences of "loneliness to pangs of loss" and of "deep escape to deep connection." The actual parasites take on symbolic significance and become the worm that inhabits us all, whether we be sick kids or weary health care providers.

Pale, gaunt children from the backwoods hills of Kentucky bring their stool specimens to school so the visiting physician can check for worms. But these sinewy kids come from a long line of leathery ancestors "bred from one tough root"--and they keep on surviving whether they have worms or not. They "shall inherit" the earth, whether or not physicians treat them.

Many of these poems are confessional accounts of gay love and sexuality. Another group clearly draw on the author’s clinical experiences as a physician. A few poems (e.g. "For You All Beauty", "Her Final Show") mix those broad categories in talking about the care of AIDS patients.The 11 short poems under the sequence title "Ten Patients, and Another" are the most clinical. They mimic clinical presentations during rounds in several ways: individual poems under patient initials--Mrs. G, John Doe; opening lines with the patient’s age, race, and gender; even presenting complaints with hospital shorthand. For example, in "Kelly" Campo begins: "The patient is a twelve-year-old white female. / She’s gravida zero, no STD’s. / She’s never even had a pelvic. One / month nausea and vomiting. No change / in bowel habits. No fever, chills, malaise." But in this poem and others of the sequence, the clinical gradually turns to the personal: "Her pelvic was remarkable for scars / At six o’clock, no hymen visible, / Some uterine enlargement. Pregnancy / Tests positive times two. She says it was / Her dad. He’s sitting in the waiting room."The cumulative effect of the series is a kind of horror at hospital cases and how they get there: a three-year-old who’s ingested cocaine, a homeless man with eyelids frozen shut, one man beaten, another man shot, an abused wife, a suicide, a drug overdose. To feel empathy for these cases, and to turn them into poetry, Campo has practiced the art of medicine as a form of love.Campo also writes as a patient who has experienced a serious arm fracture and subsequent threat of cancer in the 16-poem sequence "Song Before Dying." This changes his perspective on care-giving, as he writes in "IX. The Very Self." " . . . more dying waits / Downstairs for me. I almost hear their groans. / Same hunger, bones. Same face we all consumed. / As I examine them, I find the tomb / Toward which they lead. I know it is my own."